The anatomic variations of the posterior talofibular ligament associated with os trigonum and pathologies of related structures

Gürsoy, Merve; Dag, Fatih; Mete, Berna Dirim; Bulut, Tuğrul; Uluç, Muhsin Engin

doi:10.1007/s00276-015-1428-5

Cited by 19 publications

(20 citation statements)

References 15 publications

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“…This theory is supported by Gursoy et al's findings in their 2015 retrospective MRI study. In this study, they found an association between the presence of an os trigonum and an increase in signal intensity throughout the lateral ankle ligaments, which pointed towards chronic instability [25]. Despite this, pure ankle dislocation has not been reported as a complication following excision of symptomatic os trigonum without repair of the PTFL insertion.…”

Section: Discussionmentioning

confidence: 63%

“…Normally, the PTFL short fibers run from the fibula to the lateral talus whereas the long fibers run from the fibula to the posterior-lateral process of the talus [24]. If an os trigonum is present, then the long fibers attach directly onto the os, which is only attached to the talus by a synchondrosis 3 Case Reports in Orthopedics [25]. We hypothesize that this results in an anatomic "weak link" in the ankle due to the synchondrosis being less robust than the bony malleolus and the normal PTFL attachment.…”

Section: Discussionmentioning

confidence: 99%

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Isolated Posterior Medial Ankle Dislocation with Associated Os Trigonum Dislocation after Low-Energy Mechanism

Irving

Geers

Lawrence

2020

Case Reports in Orthopedics

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We describe a case of an isolated posteromedial ankle dislocation, without malleolar fracture, with associated dislocation of an os trigonal process after a low-energy tennis injury. We demonstrate that nonoperative treatment results in excellent functional outcome scores with minimal arthritic progression at 2 years of follow-up. We discuss pathoanatomic risk factors of pure dislocations and propose that an os trigonum is a risk factor for isolated dislocations of the ankle.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Isolated Posterior Medial Ankle Dislocation with Associated Os Trigonum Dislocation after Low-Energy Mechanism

Irving

Geers

Lawrence

2020

Case Reports in Orthopedics

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“…may become symptomatic after a simple sprain, as has been reported for other skeletal variations at the talus, like the os trigonum and talus bipartitus (bipartite talus, frontal cleft). 1,8,20 All of the symptomatic patients in our series and 4 of the 6 symptomatic patients in the literature were adolescents or young adults. Talus secundarius is therefore likely to become symptomatic upon complete ossification.…”

Section: Discussionmentioning

confidence: 74%

“…However, a hitherto asymptomatic ossicle may become symptomatic after a simple sprain, as has been reported for other skeletal variations at the talus, like the os trigonum and talus bipartitus (bipartite talus, frontal cleft). 1,8,20…”

Section: Discussionmentioning

confidence: 99%

Talus Secundarius: Case Series

2020

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Background: Talus secundarius is a very rare accessory bone at the lateral border of the foot. It is attached via a synchondrosis or small synostosis to the lateral aspect of the talar body and has additional facets to the tip of the lateral malleolus and the superior aspect of the calcaneus. Methods: Over a period of 8 years, we have seen 5 patients with 6 cases of talus secundarius with an average age of 17 years at first presentation to the senior author. One ossicle was an incidental finding and completely asymptomatic. In the other 5 cases, the average duration of symptoms was 21 months at that time. In 3 cases, additional accessory bones were seen around the talus. Results: The average size of the ossicles was 18 × 12 × 8 mm. Complete removal resulted in considerable pain reduction without further functional restriction in 4 cases. Two cases (1 asymptomatic, 1 with mild intermittent symptoms) were treated nonoperatively. The average Foot Function Index improved from 22.6 to 4.8 in all patients and from 31.0 to 4.5 in the patients treated with excision for symptomatic talus secundarius ( P < .01). Conclusion: The knowledge of accessory bones at the foot is important, as missed diagnosis may lead to prolonged course of pain and unnecessary protection in the affected patients. Resection of symptomatic ossicles substantially reduces pain, but patients have to be counseled that some symptoms may prevail in a congenital deformity. Level of Evidence: Level IV, prospective case series.

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“…With respect to these unique functions, the native shape of the talus is also unique and asymmetrical because of its three articulations with the tibia, fibula, navicular bone, and calcaneus. Several ligaments attach the talus to its surrounding articular structures [12]. Based on these exclusive characteristics, the talus is prone to several pathologies and injuries, but the native talus is difficult to reconstruct or duplicate in patients with conditions such as peritalar instability [13], talar bone damage [14], and loss of the talus [2].…”

Section: Plos Onementioning

confidence: 99%

Morphometric geometric differences between right and left human tali: A cadaveric study of fluctuating asymmetry via systematic measurement and three-dimensional scanning

et al. 2020

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Background Little is known about differences in the size and morphology of the right and left human tali. The present study demonstrates differences between right and left talar morphometric geometric profiles as fluctuating asymmetry in matched pairs of cadaveric specimens. Methods In total, 24 tali were collected in this study. All eligible tali were systematically measured with a Vernier caliper and three-dimensional laser scanner, which provided data for further analysis regarding the talar morphometric geometric profiles. Data were calculated to demonstrate differences between the right and left talar profiles using a matched-pair method, including the general size of the talus. Results The average talar length was 53.5 mm, the average talar dome height was 31.2 mm, and the average talar body width was 41.3 mm. The average anterior trochlear width, middle trochlear width, posterior trochlear width, and trochlear length were 31.8, 31.2, 28.3, and 30.7 mm, respectively. Eleven matched pairs of intact tali were eligible for the matched-pair study. Paired t-tests showed significant differences in the talar dome height (P = 0.019), middle trochlear width (P = 0.027), and posterior trochlear width (P = 0.016) between the right

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The anatomic variations of the posterior talofibular ligament associated with os trigonum and pathologies of related structures

Abstract: In patients with os trigonum, the posterior fibers of the PTFL were inserted herein. In the case of an os trigonum signal alterations of ligaments were more common, which may reflect chronic instability.

Cited by 19 publications

References 15 publications

Isolated Posterior Medial Ankle Dislocation with Associated Os Trigonum Dislocation after Low-Energy Mechanism

Isolated Posterior Medial Ankle Dislocation with Associated Os Trigonum Dislocation after Low-Energy Mechanism

Talus Secundarius: Case Series

Morphometric geometric differences between right and left human tali: A cadaveric study of fluctuating asymmetry via systematic measurement and three-dimensional scanning

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